Be a Hero in Someone’s Eyes

You too can change lives and literally become a hero for others simply by deciding to sign a donor card pledging your eyes or corneas after death. Below is the Eye Donor Form which you can fill-up.

After submitting the Eye Donor Form, a Donor Form Code will be sent to your e-mail giving you access to print your temporary donor card. Have it signed by your indicated witnesses, discuss your decision with your family, and keep the donor card with you all times.

Checkout Donor Form Code

Enter Donor Form Code to checkout your card.

Please provide your email address.
Please provide a valid donor form code.

Eye Donor Form Content

Sign the pledge form and the Donor Card and make sure to have them signed by two witnesses.

Please provide your first name.
This is optional don't worry
Please provide your last name.
Please provide your birthdate.
Please provide a valid email address.
Please provide your contact no.
Please provide the witness #1 name.
Please provide the relationship to donor.
Please provide the witness #2 name.
Please provide the relationship to donor.

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You may receive an email from us for donor verification purposes.